Individual provider Active NPI

Jacqueline Reese-Smith, PHD

  • Counseling Psychologist
  • Little Rock, AR
National Provider Identifier
1275028193
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
2017042119 Issued in MO
Practice address
4300 W 7TH St
Little Rock, AR 72205-5446
Phone
(913) 735-3002
NPI assigned
Jun 22, 2018
Last updated
Feb 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 39071 TX
Counseling Psychologist 103TC1900X 2017042119 MO Primary

Addresses

Primary practice location

4300 W 7TH St
Little Rock, AR 72205-5446

Mailing address

4300 W 7TH St
Little Rock, AR 72205-5446
Phone (913) 735-3002

Other names 1

  • Dr. Jacqueline Yvonne Reese Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2017042119MOMDCounseling Psychologist
39071TXMDCounseling Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1275028193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W 7TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055446",
            "telephone_number": "913-735-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W 7TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055446",
            "telephone_number": "913-735-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE-SMITH",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "39071",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MO",
            "license": "2017042119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "REESE",
            "middle_name": "YVONNE",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.